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APPLICATION - LOT CINE ADJUSTMENT <br /> yi SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> q CIFOA? <br /> Existing <br /> Parcel Number Existing or Proposed Use of Parcel Acreage <br /> Proposed Square <br /> Footage or Acreage Footage or Acreage <br /> 1 Agriculture 2.50 acres <br /> 2 Agriculture 2.50 acres <br /> 3 <br /> Agriculture 67.19 acres <br /> SITE IMPROVEMENTS AND SERVICES <br /> Public Water Service Provider Annex Formation Required Distance to Public Water(Feet) <br /> Proposed o Existing <br /> 0 <br /> P-ivar_ Water X Existing Well New Well o Well Repiecement <br /> wage Disposal <br /> Public gewage <br /> Disposal Service Provider Annex-Formation Required Distance to Public Sewer Facility <br /> Proposed o Existing <br /> On-site Sewage Disposal X Existing Septic System New Septic System ❑ Other u <br /> Public Storm � _ :,. � - � s i� •.. .- <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage to: Detention-Retention Ponds <br /> Proposed ❑ Existing Required <br /> ❑ <br /> Private Storm Drainage On-site Retention Pond(s) —. Natural Drainage'No Change X Other <br /> Electricity Telephone Service <br /> Service Provider Uistance to Service Service Provider Uistance to Service <br /> PG&E existing SBC existing <br /> School Service Fire Protection Service <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> Banta 2 miles Tracy 2 miles <br /> Existing Roads-. <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Lovely Road 60' 26' (estimate) Yes❑ No X Yes o No X <br /> Bird Road 72' & 60' 28' (estimate) Yes n NoXI Yes o No X <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> N/A Yes❑ No❑ I Yes o No n <br /> Yes o No❑ Yes o No 0 <br /> F:DEVSVC/Planning Application Forms/ <br /> Lot Line Adjustment doe. (Revised 06-04-04) Page 2 of 3 Job No 2005-125 <br />